Week 1 Introduction PDF

AN INTRODUCTION TO ETHICS AND MEDICAL LAW TASH PILLAY M B A : H E A LT H C A R E L E A D E R S H I P P G. D I P : B U S I N E S S A D M I N I S T R AT I O N P O S T G R A D C E RT: P R A C T I C A L L A B O U R L AW P O S T G R A D C E RT:...

AN INTRODUCTION TO ETHICS AND MEDICAL LAW TASH PILLAY M B A : H E A LT H C A R E L E A D E R S H I P P G. D I P : B U S I N E S S A D M I N I S T R AT I O N P O S T G R A D C E RT: P R A C T I C A L L A B O U R L AW P O S T G R A D C E RT: M A M M O G R A P H Y B.TECH.RAD. DIAGNOSTIC  Welcome and Introductions Names will be called out by me as they appear on the screen. Please switch on your camera when you introduce yourself. Tell us: Your name? What course are you registered for? Why did you choose to study this course? What are your expectations of the ETML course? HOUSEKEEPING  Format of online Engagements Lectures, the use of additional software... Reading and reflections.... Group discussions, engagements. ? Guest Speakers/ Industry Guru’s Objectives of the module ETML 101 The purpose of this course is to equip healthcare practitioners with the knowledge and application of the foundational principles of Ethics and South African Medical law. Students will be introduced to the linkages between medical law and the professional ethical guidelines in the South African health context for the enhanced provision of legally compliant health services in their workplaces. Empower healthcare students to respect the rights and dignity of vulnerable people they will serve and interact with as a health professional.  Assessments Written Theory test Group Assignment Class Engagement/Discussion  Class exercise Type the following url into your web browser www.menti.com Once you are logged on, use the code on the site to answer the following question: Which words come to mind when you hear the words Ethics and Medical Law?  Definitions Ethics- Derived from the greek word Ethos, which means custom or character. Signifies “Moral Values” Medical Ethics- “Moral principles by which Healthcare practitioners are governed in their interaction with patients, each other and within a healthcare ecosystem. Medical Law-Moral philosophy Morality: synonym for ethics; system of values; extent to which action is right/wrong Moral principles that govern a person’s behaviour or the conducting of an activity Branch of knowledge dealing with moral principles. Questions: Right and wrong, good or bad Based on what? Moral conduct Investigating Evaluating Systemising, defending, and recommending concepts of right and wrong behaviour. Medical Law: is the branch of law that pertains to the rights and expectations placed upon patients and medical professionals. it is also the legal and ethical principles of medicine which provokes all kind of engaging debates. What is the importance of Ethics and Medical Law? Every medical profession is guided by ethical guidelines that are set out by Stauatory bodies, (in SA- HPCSA). These guidelines are a stricter set of expectations that is placed upon medical professionals. It is one way of ensuring that Medical Ethics are made enforceable. Medical Ethics are intended to drive the decision-making of medical professionals. Ethical principles also influence medical law which is drafted with the intention of enshrining said ethics into legally-enforcable statutes.  What is Health? The Conference strongly reaffirms that health, which is a state of complete physical, mental,and social wellbeing, and not merely the absence of disease or infirmity, is a fundamental human right and that the attainment of the highest possible level of health is a most important world-wide social goal whose realization requires the action of many other social and economic sectors in addition to the health sector “-Alma-Ata Declaration,1978”  Definition of a Health System “A health system consists of all organisations, people and actions whose primary intent is to promote, restore or maintain health” Its goals are” improving health and health equity in ways that are responsive,finally fair and make the best, or most efficient use of available resources.” Ref: (WHO, 2007)  Medical practice is frequently regarded as an ethical and legal minefield, especially in South Africa (Two-tiered system) So what helps us manage these dilemmas in an effective way? The answer is – rarely, the law, but commonly, ethics.  Background to the South African Healthcare System South African Healthcare is predominantly known as a two-tiered system (highly unequal) Public sector-state funded and caters to the majority of the population- 75% Private sector- is highly funded through individual contributions to the medical aid schemes or health insurance and serves -25% The public sector is underfunded while most South Africans can’t afford the exorbitant cost of private care. During the Apartheid era, health laws and systems violated the rights of the vast majority. The truth and reconciliation Commission of SA found that many healthcare professional during this time violated the rights of people under their care. Years later the government has tabled the NHI (National Health Insurance Scheme) that will provide universal healthcare by buying services from health professionals through a National Health fund. Should patients be treated better simply because they can afford to pay more???  What governs Healthcare in South Africa? The Constitution of the Republic of South Africa, 1996, places obligations on the state to progressively realise socio-economic rights, including access to healthcare. Section 27 of Chapter 2 of the Bill of Rights of the Constitution states the following with regard to healthcare, food, water and social security: ‘Everyone has the right to have access to healthcare services, including reproductive healthcare; sufficient food and water; and social security, including appropriate social assistance if they are unable to support themselves and their dependents.’ The state must take reasonable legislative and other measures within its available resources to achieve the progressive realisation of each of these rights, and no one may be refused emergency medical treatment. Department of Health (DOH) derives its mandate from the National Health Act 61 of 2003 provides a framework for a structured uniform health system within the Republic of South Africa taking into account the obligations imposed by the Constitution and other laws on the national, provincial and local governments with regard to health services; Statutory Bodies (Health Professional Councils) Allied Health Professions Council of South Africa Health Professions Council of South Africa National Health Research Ethics Council South African Dental Technicians Council South African Nursing Council South African Pharmacy Council  HEALTH PROFESSIONS COUNCIL OF SOUTH AFRICA A statutory body, established under Section 2(1) of the Health Professions Act 56 OF 1974 Encompasses 12 Professional Boards Is dedicated to promoting public, determining standards for professional education and training, and maintaining high standards of ethical and professional practice. Serves to protect the public and guide the professions, the council ensures that practitioners uphold and maintain the highest professional and ethical standards within the health professions. The council diligently investigates complaints against practitioners and ensures that strict disciplinary action is taken against those who fail to comply with these standards. Mission: To regulate and guide registered healthcare professionals and protect the public through: Establishing contextually relevant standards for healthcare training and practice. Setting and maintaining standards for ethical and professional conduct. Enhancing the maintenance of continuing competency programs. Ensuring consistent compliance with all established standards. Continuously engaging the public and other stakeholders. Core Operations: (Registration as a health care practitioner, and Governance of Professional Practice) Being registered as a healthcare professional with the Health Professions Council of South Africa (HPCSA) confers one the right and privilege to practise a profession. Correspondingly, practitioners have moral and ethical duties to others and society in general. These duties are, in part, in keeping with the principles of the South African Constitution (Act No. 108 of 1996) and the obligations imposed on healthcare professionals by law. Qualifying in any healthcare profession carries significant personal responsibility, and as a practitioner, one must adhere to several legal obligations. Registration with the Health Professions Council of South Africa (HPCSA) is mandatory for professional practice, and it is legally required to keep personal details updated at all times. As a healthcare practitioner one is obliged to pay an annual fee for this registration, and failure to do so can lead to suspension from the register. If a practitioner is suspended, they are allowed to apply for restoration by paying the restoration fee. Additionally, voluntary erasure from the register is an option if you do not intend to practice your profession in South Africa for a certain period. Professional Practice: 5 sub-portfolios under this division Business Practices Practitioners Impairment Scope of Profession and practice Continuing Professional Devevelopment ETHICS and HUMAN RIGHTS  ETHICS and HUMAN RIGHTS Health professionals registered with the Health Professions Council of South Africa (HPCSA) are not only granted the right to practice their professions but are also entrusted with profound moral and ethical responsibilities towards individuals and society. These responsibilities are deeply intertwined with the principles enshrined in the South African Constitution, 1996 (Act No. 108 of 1996), and the legal obligations imposed on health practitioners by various statutes. The domain of Ethics, Human Rights, and Health Law encompasses the bioethical principles guiding health practitioners in their research and interactions with patients, clients, and society, as outlined in Chapters 1 and 2 of the South African Constitution. As healthcare evolves rapidly, new conflicts frequently emerge at the intersection of politics, law, religion, philosophy, and economics. A robust understanding of bioethics equips health practitioners to identify, acknowledge, and navigate these complex conflicts effectively.  Core Ethical Values and Standards for Good Practice The foundation of good professional practice lies in core ethical values and standards, with the standards serving as directives that stem from these core values The core ethical values and standards required of healthcare practitioners include the following: ❑ Respect for Persons ❑ Best Interests/Well-being of Patients ✓ Beneficence: Healthcare practitioners are duty-bound to act in the best interests of their patients, regardless of any conflicts with their own personal interests. ✓ Non-Maleficence: Healthcare practitioners must not harm or act against the best interests of patients, even when the interests conflict with their own. ✓ Human Rights: Healthcare practitioners must recognise and respect the human rights of every individual ✓ Autonomy: Healthcare practitioners must honor patients' right to self-determination, empowering them to make informed choices and live according to their own beliefs, values, and preferences. ✓ Integrity: Healthcare practitioners should incorporate these core ethical values and standards as the foundation for their character and practice ✓ Truthfulness:Healthcare practitioners must regard the truth and truthfulness as the basis of trust in their relationships with patients. ✓ Confidentiality: Healthcare practitioners must uphold the confidentiality of personal or private information in their professional relationships with patients, unless there are compelling ethical or legal reasons that necessitate disclosure. ✓ Compassion: Healthcare practitioners should be attuned to and empathize with the individual and social needs of their patients, striving to create mechanisms for providing comfort and support whenever appropriate and feasible. ✓ Tolerance: Healthcare practitioners must respect individuals' rights to hold different ethical beliefs, recognizing that these may stem from deeply held personal, religious, or cultural convictions. ✓ Justice: Healthcare practitioners must treat all individuals and groups impartially, fairly, and justly. ✓ Professional competence and self-improvement: Healthcare practitioners must continuously strive to achieve the highest level of knowledge and skills in their area of practice. ✓ Community: Healthcare practitioners should aim to contribute to the betterment of society, aligning their efforts with their professional abilities and community standing.  ETHICAL DILEMMAS Medical treatment frequently encounters ethical dilemmas The advancement of medicine not only leads to improved solutions for medical issues but also gives rise to new ethical challenges that were previously non-existent. The primary goal of medical ethics is to recognize these dilemmas and establish ethical decision-making processes to address them to some extent. Ethical decision-making in medicine involves considering principles such as patient autonomy, beneficence, non-maleficence, justice, and respect for individuals' rights and dignity. These principles serve as guiding frameworks for healthcare professionals when confronted with ethical dilemmas in medical practice.  Medical treatment continually faces ethical dilemmas, with the progress of medicine introducing new ethical challenges that were previously non-existent. This underscores the importance of medical ethics in identifying and addressing these dilemmas effectively. The purpose of medical ethics is not to eliminate ethical dilemmas entirely but to develop ethical decision-making processes that assist in navigating and resolving these dilemmas to some extent. Ethical decision-making in medicine involves considering principles such as patient autonomy, beneficence, non-maleficence, justice, and respect for individuals' rights and dignity. These principles serve as guiding frameworks for healthcare professionals when confronted with ethical dilemmas in medical practice. The ethical dilemmas in medicine are diverse and multifaceted, ranging from issues related to informed consent and end-of-life care to resource allocation, confidentiality, conflicts of interest, and genetic testing and counseling. Each of these dilemmas requires careful consideration and application of ethical principles to ensure the best possible outcomes for patients while upholding ethical standards in healthcare. Addressing medical ethical dilemmas requires collaboration among healthcare professionals, patients, families, ethicists, and policymakers to develop comprehensive approaches that prioritize patient well-being, respect individual rights, and promote ethical decision-making in medical practice. As medical technology and knowledge continue to advance, the field of medical ethics will evolve to address emerging ethical challenges and dilemmas. Continuous education, training, and ethical reflection are essential for healthcare professionals to navigate complex ethical issues and uphold the highest standards of ethical conduct in healthcare delivery.  Interesting Videos https://www.youtube.com/watch?v=UorUyptgG6g https://www.tiktok.com/@dr.z_neurosurgery/video/7382006632357711147 https://www.youtube.com/watch?v=3xnyvynoaxY  ASSIGNMENT “The Ethical and Legal Implications of Informed Consent in South African Healthcare: A Critical Analysis" This topic explores the principles of informed consent, the legal requirements in South Africa, and the ethical considerations involved. It also encourages an analysis of real-world cases and to ability to propose recommendations for improving practices in the South African healthcare system. REQUIREMENTS: Groups: 4-5 students Pages: 8-10pages Referencing: Harvard Referencing Due Date: Second week of October (Date to be confirmed)  TAKE HOME Ethics is an inherent and inseparable part of clinical medicine Ethics is the investigation and evaluation of human action relating to good/bad; right/wrong Ethical Standards framework embraces key principles of ethical decision making within healthcare. Modern healthcare is Collaborative and communication with patients is key to avoiding ethical violations/dilemmas Healthcare is a worthwhile and respected profession in the community but there are necessary ethical and legal responsibilities that have to be considered while working it.  SELF READING 1. What are the professional responsibilities of healthcare workers in treating patients with COVID-19, given the undeniable high risk of infection they face? Do healthcare providers possess the right to refuse treatment to COVID-19 positive patients, or are they bound by a professional duty to provide care, regardless of the personal risk involved? 2. How has the COVID-19 pandemic posed challenges to prioritizing patient confidentiality? What are the best practices for reporting positive cases to the public and hospital staff?